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Paragon Clinician Hub for Physicians (PCH) Reference
Logging in to the Clinician Hub
Paragon Clinician Hub (PCH) is available on any Carroll Hospital Network. VMWare View
must be utilized to open the application. Double Click on the VM View icon on your
desktop
Note: Please make sure the Domain is hospital.com and the Environment is LIVE. Now enter your USERNAME and PASSWORD
LIVE
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Searching and Adding Patients to Your Census
1. If you have no desire to see anything other than patients you are the attending, admitting,
consulting or primary care provider for, leave your filters alone. You will see all of those patients
inpatients and outpatients.
2. However, if you wish to always see yours and your group’s patients, and only see patients that
you are rounding on, you must set up and save a ‘filter.’ First, click on Groups row in left hand
filter column. The groups you are part of will appear.
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3. Check the individual group boxes, or the All box and ‘X’ out.
4. Next, click on Patient Type in the left hand column and choose the patient types you would like
to see on your list. All clinicians should choose Inpatient and Observation. Others may want to
add Emergency Room, Psychiatric, L&D Outpatient, Partial Hospitalization, or Series Wound
Care, Triage, or whichever patients you commonly round on.
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5. To remove Pre-Registration and/or Recently Discharged patients from your census, click on
Status then uncheck Pre-Registration and/or Recently Discharged. Then, click on the “x” to the
right of the field.
6. After your patients display, click the Save (Filter) Button. Type in the blank field, ‘My Group’s
patients’ (or whatever you prefer) and click the save button to the right of the field.
7. Click the ‘Set as Default’ link.
You are finished setting up your filters!
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You now have your Census! You can view your work list or select an individual patient.
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Performing A Patient Search
1. The Patient Search field provides the ability to search for patients by name, medical record
number (MRN), or Visit ID.
2. To see all patients and patients that have been discharged, click “Options”, then uncheck
“Include Active Only”
As you start typing in the Name, MRN, or Visit ID, options will start to populate.
Note: A minimum of three characters must be entered for the name before the system begins a search. The patient search results list 15 patients that have the last names containing the characters entered. Last name matches are displayed first, followed by first name, and then middle name.
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3. Click on the desired patient.
Patient List Information
A CodeStatus, if applicable. For example, DO NOT RESUSCITATE. (Placing the
mouse pointer over this field displays the entire code status description.)
An Isolation indicator, if ordered.
• Number of Alerts in the Workqueue for the patient
• Number of Tasks in the Workqueue for the patient
• Pregnancy indicator (if yes)
• Patient name(Last, First, MI) Note: If the Secure check box was selected for the
patient on the Visit Maintenance window in Registration, the text SECURED displays in red text to the MRN.
• DOB, Current Age, Gender
• Medical Record Number
• The text "Aliases" displays followed by the number of aliases for the patient
• Location(Nursing Station/ Room/ Bed or Outpatient location)
• DECEASED displays in red if the patient has been marked as deceased/expired in
Registration.
• The text "Patient Alerts" followed by the number of active patient alerts. Hover to
view.
• Admit date and time followed by the length of stay in parentheses Hover to view.
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• Attending physician
• Race
• Primary Care Physician(PCP) name(if entered)
• Admitting diagnosis and any additional diagnoses
• Registering Facility
• Visit Status
• Patient Type
• Service
• Length of Stay(in days)
• Discharge date(if applicable)
Clicking the More Hyperlink opens the list in expand view.
Reports
Here you can choose an action:
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Rounding Report:
This report is sorted by facility, nursing station, and room-bed. Patient/visit information includes the
patient’s age, sex, admit date, attending physician, primary care physician, and admitting complaint if
entered at the time of registration. The report also includes a calculated length of stay.
Face Sheet Report:
The face sheet generated from Clinician Hub is a pre-defined report that includes the following types of
data: Patient Information, Emergency Contact, Visit Detail, Caregivers, Guarantor Information (primary),
and Payor Information (for each pay or in order of primary, secondary, tertiary, etc.).
**Note: The patient must be highlighted before clicking the dropdown “Select An Action”
Selecting a Patient
Click on the Patients blue name. It will open the patient to the “Overview” screen.
Unlocking an Application: (Replacing the Black Lock in WSP)
1.) Have the patient in Focus
2.) Click the down arrow for your username and select Super User option.
3.) The Super Authority window opens and you can unlock the application
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Patient Overview
The Overview window includes the following information about a patient:
• Vital sign data
• Intake and output data
• Active and recently ended inpatient medications and IV therapies
• Laboratory, Radiology and Ancillary results
• Active and recently ended orders
You can change the time frame while viewing from the Overview window.
Click the Overview Time Interval field
Select value; 4,8,12,24,48,or72hours
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Documentation
With the patient in focus, click on the “DOCUMENTATION” tab.
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Viewing Medical Records
Have patient in focus and click dropdown
Select Medical Records
MPF will launch
One Content now displays. If you wish to display a document or report on the right, click on it in
the left-hand column (document tree).
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**To exit out of Medical Records, Click on another tab. Do Not click “CLOSE” on the top right if you want
to stay on that patient**
***If you want the document to take up your whole screen, click on the little up arrow to collapse the
side column***
Patient Sidebar
The patient sidebar provides access to the Patient Work queue and the Patient Profile data for the patient in focus.
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Allergies:
To view allergies click on the “Patient Workqueue” and select “Allergies”.
Existing active allergies display in a collapsed view below the “Manage” button.
The system also displays whether the data is Unverified or Verified.
Clicking the “Manage” button will bring up the “Manage Allergies” window
Clicking the button will allow you to edit the Allergies.
If a yellow triangle will appear if the Allergy is non-coded.
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To Add an Allergy
Click the Add button
The “New Allergy” window will open
Type in the first few characters of the allergy in the “Allergy” field. The allergies matching the characters entered display in the drop-down list.
If you want to enter any notes regarding the allergy, type them in the “Notes” field. Up to 150 characters can be entered
Inactivating an Allergy
In the Allergy window click the pencil icon next to the Allergy you want to inactivate.
Scroll to the bottom of the window and select Inactive in the Status field. The “Reason for Inactivating” window opens.
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Type in the reason and click the Accept button.
Patient Demographics
To view the patients demographics, select ”Demographics” in the drop down.
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Family History
Select family history in the dropdown.
You can view more information by
expanding on one of the names or hovering
over the name.
Click the “Manage” button to open the
Manage Family History window.
To add family history click the “Add”
button.
Immunizations
Select Immunizations in the dropdown.
Existing active immunizations display
below the “Manage” button
Click the “Manage” button to open the
Manage Immunizations window.
Medications and IVs
Select Medication and IVs in the
drop down.
All medication and IV orders are displayed for the patient. The data is view only.
The orders are grouped as follows: Stat, Routine, PRN, and IV Solutions
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Non-Hospital Medication
Non-hospital medications include pre-arrival
medications and home medications
Select “Non-Hospital Medications” in the drop-
down list.
The “Home” icon displays next to Home Medications.
The text "(Pre-Arrival)" displays in green next to pre-arrival medications.
To see additional information about the medications, click the “Expand” down arrow.
To manage home meds, change the “All Meds” dropdown to “Home Meds” then “Manage”.
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Click the pencil to edit or the “ADD” button to add a medication.
Clicking the “ADD” button will bring up the “Medication Search” window.
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Viewing Non-Med Orders
Select “Non-Med Orders” in the dropdown
The orders are grouped as follows: Active (including Future orders), On Hold, and Recently Ended.
You can change the “Time Interval” by clicking on the drop down and selecting 4 Hours, 8, Hours, 12 Hours, 24 Hours, and 72 Hours
Viewing and Editing Problems and Procedures
Select Problems and Procedures in the
dropdown.
The default is “ALL” but you can change it to Active, Inactive, Chronic,
Intermittent, or Rule Out in the drop-down
Click the Manage button to open the
Manage Problems window
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Note: By default, the Current List displays all entries regardless of their status. The Full List displays Active entries.
The Note icon displays if there are notes entered related to
the problem.
To add a problem click the “ADD” button. The “Problem Search”
window will open.
In the Search String field, type three or more characters for the problem. As you type, a drop-down list appears matching the characters entered
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Once you select the desired entry, the “New Problem” window opens
To edit a problem, click on the pencil next to the problem and the “Edit Problem” window
opens.
Select the desired status (Active, Inactive, Chronic, Intermittent, Recurrent, Rule Out, Ruled Out, Resolved, Completed, or Entered in Error) in the Status drop-down list.
Flowsheets
You can access the flow sheets two ways:
1. Click on the patient’s name so they are in focus. On the overview tab you can click on the
in the top right corner of a pane to open the corresponding flowsheet.
2. Have the patient in focus and click on the flowsheet tab at the top
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You can choose to view one or multiple visits at once.
Note: Icons to remember when viewing Flowsheets
Icons Description
Significant icon - Indicates a value that is considered significant for the patient.
Abnormal icon - Indicates a value that is considered out of range based on normal ranges
Multiple Folder (multi-views) icon - Indicates the presence of multiple entries for the time interval.
Progress Note icon - Indicates the presence of a progress note. Clicking on this icon opens the Progress Note pop-up window displaying the note.
Note icon - Indicates the presence of a note.
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Intake and Output Flowsheet:
Information entered in Clinical CareStation is display in this flowsheet.
Medication Administration Record Flowsheet:
The standard MAR flowsheet groups medications as follows:
Routine, including all active medications on the patient's Pharmacy profile with the exception of PRN medications:
Unscheduled medications
Scheduled medications
Intravenous (IV)medications
IV piggy back (IVPB) medications
Chemotherapy medications
Respiratory medications
PRN, including all medications with a PRN frequency
Icon Description
Multiple folder icon - Indicates the presence of multiple entries for the time frame.
Medication not given
Medication is on hold
Medication had a scheduled dose
Medication is currently overdue
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Nursing Documentation Flowsheet:
The following will display on the Nursing Documentation Flowsheet:
Vital Signs (including pain scores entered as vital signs)
Ventilator/Bed data
Measurements
Assessments (including pain scores entered as part of an assessment)
Progress Notes
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Results Flowsheet
The Results Flowsheet includes lab, microbiology, diagnostic imaging (radiology), cardiology, and other.
You can view multiple visits at once by clicking the “Select Visit” drop down and select your visits.
More Flowsheets: You can customize what flowsheets appear
Click on “More Flowsheets” and then “Manage Flowsheets”
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Once you find the flowsheet on the left, click and drag it to the right. You can have them in any order.
Click “CONFIRM” when you are finished selecting your Flowsheet.
**The Flowsheet with the lock icon cannot be removed. You can only change the order.
CPOE (Computerized Provider Order Entry
Have your patient in focus and select the “Ordering” tab
You will be able to search for orders by using either Order Sets or individual orders. Click on the
Search button.
For this example, I wanted to search the order sets for Potassium Aliquots. All order sets are
preceded by an asterisk (*).
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In this example, I will select
Potassium Chloride IV Aliquots
Order Set. Once you have
entered the order, select your
desired dose.
Your order will appear on the
right hand screen. Then Click
Submit.
Lab Ordering
To order a lab, click on Search. In the search field enter the desired lab. Once you have found
your lab, click on it.
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Complete the areas with a red asterisk (*)
When all required fields are completed, click on Submit.
To save all of your orders, click on Save. Please LIMIT saving orders and order sets. It is ALWAYS
preferable to submit your orders at the time of entry to reduce the likely hood of forgetting to
sign the orders. Submitting orders is equal to signing orders.
Radiology Orders:
Enter your Radiology order into the search field. With Radiology ordering, you will have an
additional required field which is the reason for performing the test.
Medication Orders:
Medication will be entered in the same fashion. You will have opportunity for practice during
your computer training
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Order Sign-Off:
You can sign off orders two ways:
1. Once the patient is in focus, you select the “Bulk Order Sign” option in the “MORE” drop-down.
2. In “My Workqueue” you can
click on “BULK SIGN OFF”
Once selected, the patient’s
orders window will appear.
Select the orders you would like to sign off then click the “Sign-Off” button.
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Work queue
In clinician Hub there are two work queues: “My Workqueue” and “Patient
Workqueue”.
Patient Workqueue shows to the left of the screen when the patient is in focus.
My Workqueue shows to the right of the screen and includes tasks for all your patients. It can
be viewed at any time.
Icon Description
CriticalAlert – Selected and Not selected
Abnormal Result
Regular Alert - Not selected
Regular Alert - Selected
Task- Not selected
Task- Selected
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My Workqueue: You can filter your workqueue by clicking on the “View” or “Sort By” dropdown.
Note: Critical Alerts display at the top of the list and are highlighted in red.
The ordering physician and all members of the care team for the patient
receive Abnormal and Critical Result alerts. The system removes an
Abnormal or Critical alert from the Patient Workqueue and My Workqueue
for all who received it and replaces it with a New Result alert if the results
are corrected to be normal. In addition, if New Result alert is later
corrected to Abnormal or Critical, the Patient Workqueue and My
Workqueue are updated accordingly.
Tasks that can be found in your Workqueue are the following:
Complete Document
Co-Sign in CPOE
Co-Sign PhysDoc
Medication Reconciliation
Medication Order Renewal
Sign Off for Orders
Sign-Off Reject (Wrong Physician)
Unsubmitted Order
Click on any item in your workqueue
to view.
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Click on the drop down to select an action
Select “VIEW RESULT REPORT” or “PUT PATIENT IN FOCUS”
ONLY CHOOSE “ACCESS CPOE”, “ACCESS FLOWSHEET”, and “ACKNOWLEDGE” if you are
planning to take action. It will remove that task from yours and your group’s workqueue.
Medication Reconciliation
To begin, click on the green Admission Medication Reconciliation START tab
Home meds vs Inpatient meds will display to prevent duplication
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You will be required to Continue, Defer, Hold, Modify, or Discontinue medications. Be mindful
that the Green home icon identifies the home medication.
With Paragon, click on the Add order button to automatically order the reconciled medications.
You must do this prior to clicking on the complete button.
You may experience messages such as seen below. It is important to almost ALWAYS replace a
home med with a formulary item. Only in rare cases are patients allowed to take their own
home meds.
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You will know the Med Rec is complete by the checkered flag. This is McKesson’s nod to NASCAR
since Paragon is based out of Charlotte, NC.
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Deferring a Home Medication on Admission Med Rec
On Admission Med Rec, chose to
Defer this Home Med - Nexium.
Shows us like any other Home Med
would on both the Transfer Med
Recs and D/C Med Recs. No
indication it was deferred unless you
go back to the Admission Med Rec
Report and open it.
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